Sepsis is an important public health problem around the world. Severe sepsis carries significant morbidity, mortality and high costs. The incidence of sepsis is increasing because of the aging population, the growing number of immunocompromised hosts, the increasing use of invasive procedures, and, to a lesser extent, antibiotic resistance among pathogens. Despite recent advances in the pathogenesis, diagnosis, and therapeutic approaches the mortality rate associated with this condition remains high. Therefore, the goal of Sepsis: New Strategies is to review novel targets to be considered in patients with severe sepsis and to assess new developments for patients with sepsis originating in the respiratory tract.

Welcome to the City of Groningen, the center of the North of the Netherlands. Groningen is proud of the long lasting tradition of scientific symposia organised by the Sanquin Blood Bank. These Sanquin International Symposia on Blood Transfusion have become a true traditional event in Groningen, marking the early academic year and have contributed to the specific reputation of Groningen and its University in the scientific field of Transfusion Medicine. The growing tradition has also contributed to initiatives of both University, Province and the City of Groningen to bring science and industry together - BioMedCity Groningen. Such repu- tion does not just happen, but is the result of creative and scientific leadership, of vision and an open mind, to explore in a team spirit horizons. Groningen is particularly proud of this reputation thanks to its leadership, the Sanquin Blood Bank North-East. This year in particular the theme chosen some two years ago is extremely timely as it illustrates the activities and scientific interest of an integrated team which includes our regional Sanquin Blood Bank North-East and fits in the City initiatives within the concept of BioMedCity, Groningen.

Fundamentals of Frontline Surgery is an easy to read text, written by world class faculty, that provides clinicians with succinct and didactic information about what to do in high intensity, resource limited situations.With global conflicts and humanitarian emergencies on the rise, there has been a dramatic uptake in the number of volunteers for both military and humanitarian operations. This manual aids best practice and fast decision making in the field.

This book is a unique compilation of essays about the genocidal persecution fuelling the Nazi regime in World War II. Written by world-renowned experts in the field, it confronts a vitally important and exceedingly difficult topic with sensitivity, courage, and wisdom, furthering our understanding of the Holocaust/Shoah psychoanalytically, historically, and through the arts. Authors from four continents offer their perspectives, clinical experiences, findings, and personal narratives on such subjects as resilience, remembrance, giving testimony, aging, and mourning. There is an emphasis on the intergenerational transmission of trauma of both the victims and the perpetrators, with chapters looking at the question of "evil", comparative studies, prevention, and the misuse of the Holocaust. Those chapters relating to therapy address the specific issues of the survivors, including the second and third generation, through psychoanalysis as well as other modalities, whilst the section on creativity and the arts looks at film, theater, poetry, opera, and writing. The aftermath of the Holocaust demanded that psychoanalysis re-examine the importance of psychic trauma; those who first studied this darkest chapter in human history successfully challenged the long-held assumption that psychical reality was essentially the only reality to be considered. As a result, contemporary thought about trauma, dissociation, self psychology, and relational psychology were greatly influenced by these pioneers, whose ideas have evolved since then. This long-awaited text is the definitive update and elaboration of their original contributions.

Coronary artery disease is the most commonly encountered problem in adult cardiology in the world. Echocardiography is the most commonly used imaging modality encountered in cardiology practice in the world. Even though there are many Acute Coronary Syndrome (ACS) reference books and echocardiography reference books, there is no single practical book so far in the literature with focus on the combined topics. The authors believe that this will be the first book to provide information on how echocardiography can be used in, prevention, diagnosis and treatment of ACS.

Addressing the region of the upper extremity, this practical reference features contributions from 17 specialists and supplies state-of-the-art descriptions of diverse fractures, treatment approaches and surgical options. It also includes a chapter on nonunions of the upper extremity.

Brain injury is a worldwide leading cause of mortality and morbidity and requires early and appropriate management to minimize these adverse sequelae. Despite such needs, access to specialist centers is limited, forcing both immediate and secondary care of these patients onto generalist staff. These responsibilities are made more problematical by differences in patient management between and even within specialist centers, due in part to an insuffcient evidence-base for many interventions directed at brain injury. This book is borne out of the above observations and is targeted at em- gency and acute medicine, anesthetic and general intensive care staff caring for brain injury of diverse etiology, or surgical teams responsible for the inpatient care of minor to moderate head trauma. Although explaining the various facets of specialist care, the book is not intended to compete with texts directed at neurosciences staff, but aims to advise on optimal care in general hospitals, including criteria for transfer, by a combination of narrative on pathophysiology, principles of care, templates for documentation, and highly specifc algorithms for particular problems. It is intended that the content and structure can form the basis of guidelines and protocols that refect the needs of individual units and that can be constantly refned. Our ultimate goal is to promote informed, consistent, auditable, multidisciplinary care for this cohort of patients and we hope that this text contributes to that process.

The terrorist act with sarin gas in the Tokyo underground and the case with the spread of anthrax spores through the U.S. postal system stimulated the development of orga- zation of fight against terrorism on a national and global level. The goal of this wo- shop was assessment of scientific concepts and practical means for management of chemical and biological agents casualties in the area of terrorist attacks with emphasis on improving the problems and situation in Eastern European Countries. In this book are included the results of both theoretical and practical research of chemical and biological terrorism presented during the workshop. Different trends of research to fight against terrorism on both local and governmental level including some Eastern European countries are discussed. The scientific articles are grouped into those areas: - New approaches in counteraction to chemical and biological terrorism - Medical treatment and decontamination of casualties from chemical and biological agents - Diagnosis of exposure to chemical and biological agents - Development of protection against injuries from chemical and biological agents In these articles the following are emphasized: - Some aspects of national and global defense against chemical and biological terrorism - National action plans and global agreements on combating terrorism - The characteristics of the major specific injuries connected with chemical and biological terrorism - Threats of terroristic attacks - Epidemiological and clinical peculiarities, ways of diagnosing, medical tre- ment and preventive health care measures These problems are analyzed from an interdisciplinary perspective.

Demand for neuromonitoring in neonatal, pediatric and cardiac intensive care units continues to grow, motivated by increased awareness of the high prevalence of seizures among critically ill neonates and children, and emerging evidence that these seizures can contribute to brain injury. This book provides physicians, nurses and trainees caring for critically ill newborns and children with a practical overview of how to use and interpret continuous neuromonitoring to enhance patient care. Authored by international experts from diverse institutions and professional backgrounds, this is a practical guide that is accessible to intensive care specialists, but also comprehensive enough to serve as a reference book for neurologists and neurophysiologists. Concise enough to be read cover-to-cover and illustrated with over thirty case-based examples, this authoritative reference will guide readers in accurate neuromonitoring interpretation and optimal use of conventional EEG, amplitude-integrated EEG and other quantitative EEG techniques.

ABC of Transfer and Retrieval Medicine provides the key information required to help health care professionals involved in the movement of critically ill patients to do so safely, correctly and with confidence. Beginning with the practical and clinical considerations to be taken into account during patient transfer and an overview of transfer equipment, it then addresses pharmacological aspects of patient transfer, the roles and responsibilities of the transfer team, and the requirements of neonatal, paediatric and specialist transfers. Mapped against the syllabus for the Diploma of Retrieval and Transfer Medicine (Royal College of Surgeons of Edinburgh), it has been developed as a core resource for the diploma whilst providing an invaluable resource for any healthcare professional involved in the transfer of critically ill patients including anaesthetists, intensivists, nurses from ICU/ED and paramedics. It also includes frameworks for radiology and arterial blood gas interpretation, guidance on patient triage, transfer checklists and equipment checklists, and a summary of the relevant national guidelines. From a multidisciplinary international author team, this new addition to the ABC series is a useful resource for all health care professionals involved in the transfer of patients. It is relevant to anaesthetists, intensivists, paramedics, critical care and emergency department nursing staff who are required to take part in intra and inter hospital transfers.

The care of the critically ill or injured child begins with timely, prompt, and aggressive res- citation and stabilization. Ideally, stabilization should occur before the onset of organ failure in order to achieve the best possible outcomes. In the following pages, an international panel of experts provides an in-depth discussion of the early recognition, resuscitation, and stabilization of the critically ill or injured child. Once again, we would like to dedicate this textbook to our families and to the physicians and nurses who provide steadfast care every day in pediatric intensive care units across the globe. Derek S. Wheeler Hector R. Wong Thomas P. Shanley V Preface to Pediatric Critical Care Medicine: Basic Science and Clinical Evidence The ? eld of critical care medicine is growing at a tremendous pace, and tremendous advances in the understanding of critical illness have been realized in the last decade. My family has directly bene? ted from some of the technological and scienti? c advances made in the care of critically ill children. My son Ryan was born during my third year of medical school. By some peculiar happenstance, I was nearing completion of a 4-week rotation in the newborn intensive care unit (NICU). The head of the pediatrics clerkship was kind enough to let me have a few days off around the time of the delivery-my wife, Cathy, was 2 weeks past her due date and had been scheduled for elective induction.

The ? eld of critical care medicine is in the midst of a dramatic change. Technological and s- enti? c advances during the last decade have resulted in a fundamental change in the way we view disease processes, such as sepsis, shock, acute lung injury, and traumatic brain injury. Pediatric intensivists have been both witness to and active participants in bringing about these changes. As the understanding of the pathogenesis of these diseases reaches the cellular and molecular levels, the gap between critical care medicine and molecular biology will disappear. It is imperative that all physicians caring for critically ill children in this new era have a th- ough understanding of the applicability of molecular biology to the care of these patients at the bedside in order to keep up with the rapidly evolving ? eld of critical care medicine. To the same extent, the practice of critical care medicine is in the midst of fundamental change. In keeping with the Institute of Medicine's report "Crossing the Quality Chasm," the care of critically ill and injured children needs to be safe, evidence-based, equitable, ef? cient, timely, and fami- centered [1,2]. In the following pages, these changes in our specialty are discussed in greater scope and detail, offering the reader fresh insight into not only where we came from, but also where we are going as a specialty.

As a result of arms control efforts over the past 50 years, nuclear material is subject to strict national controls and tough international treaties. But there are still almost no controls, other than a voluntary International Atomic Energy Agency code of conduct, on the sorts of radiological sources used to make radiological dirty bombs. Radiological sources are used all over the world for a wide range of peaceful purposes, including smoke detectors, medical devices, meteorology, mining and thermoelectric generators. There are at least eight million identified radiological sources worldwide. Their small size, portability and high value make them vulnerable to misuse and theft: the IAEA reported 272 cases of illicit trafficking in sealed radioactive sources between 1993 and 2002.

The IAEA estimates that 110 countries worldwide still fail to impose adequate controls. The time is ripe for an international convention and treaty on the safety and security of radiological sources.

This book covers expert discussions designed to enhance cooperation and assistance between NATO and Partner countries in support of International Atomic Energy Agency (IAEA) efforts to secure radioactive sources against the threat of terrorism and also to support the security agenda at the International Radiation Protection Association Congress in Buenos Aires in 2008.

In the Handbook of Injury and Violence Prevention, over fifty experts present the current landscape of intervention methods - from risk reduction to rethinking social norms - as they address some of the most prevalent forms of accidental and violent injury.

- Overview chapters examine the social and economic scope of unintentional and violent injury today

- Extensive literature review of specific intervention programs to prevent violence and injury

- Special chapters on childhood injuries, alcohol-related accidents, and disasters

- "Interventions in the Field" section offers solid guidelines for implementing and improving existing programs

- Critical analysis of issues involved in delivering programs to wider audiences

- Helpful appendices list relevant agencies and professional resources

This dual focus on intervention and application makes the Handbook a bedrock text for professionals involved in delivering or managing prevention programs. Its what-works-now approach gives it particular utility in the graduate classroom, and researchers will benefit from the critical attention paid to knowledge gaps in the field. It is a major resource for any reader committed to reducing the number of incidents just waiting to happen.

Mastering Emergency Medicine is a concise, revision-focused textbook that covers everything that candidates need to know in order to pass the College of Emergency Medicine's (CEM) membership examination (MCEM) to enter training, and to the pass fellowship examination (FCEM) to complete the Certificate of Specialist Training. With over 100 OSCE scenarios designed to stimulate everyday emergency department clinical encounters, Mastering Emergency Medicine covers all the key areas of the CEM syllabus, including: clinical examinations and practical skills, communication skills, teaching and management. This book takes a practical approach to the subject - core facts are presented and common scenarios are explored using an OSCE style, as used in the Part C MCEM and the FCEM examinations - which makes it an invaluable blueprint for management of cases. Closely linked to the current CEM syllabus, each chapter comprises three parts: Core topics that supplement revision for Part A and B. Clinical scenarios, including data and relevant practical skills that can be used to prepare for Parts B and C. Mock 'Scoring Scenarios' that give specific guidance on how to perform in OSCEs. Mastering Emergency Medicine is a highly detailed revision guide for the OSCE examinations and an essential study guide for all those who are preparing for the MCEM or FCEM examinations. It will also be useful to those who are wishing to pursue a career in Acute Medicine.

The forensic nurse has a powerful role in medical-legal investigations. Going beyond the nurse's traditional role, forensic nurses are often at the forefront of evidence collection and preservation. They can maintain an evidentiary chain of custody, testify as an expert witness in a court of law, care for victims, assist victims' families, and work with the community and law enforcement by providing educational programs. Forensic Nursing: A Concise Manual presents practical information directed at the range of activities that forensic nurses perform, offering guidelines for examining and correlating medical, psychological, ethical, and legal data specific to victims. The First Forensic Nursing Text to Offer a Full Range of Instructor's Materials The book begins with an introduction to the fields of forensic nursing and forensic science. It discusses crime scene and death investigation, evidence collection, autopsies, legal issues, and ethics. It examines the nursing process as an organizational tool for identifying both the medical needs of the victim and the legal aspects of crime scene investigation. The authors pinpoint the role of the forensic nurse in an array of incident scenarios, including nursing home death, excited delirium syndrome, blunt and sharp force injuries, gunshot wounds, asphyxia, child abuse, sexual assault, and intimate partner violence. They also explore human trafficking and the forensic nurse's role in mass disasters. Lastly, the book provides emergency room recommendations, discusses profiling and forensic anthropology, and offers guidance on working with grieving family members. Using a succinct outline format, the text is complemented by illustrative flowcharts and references in each chapter for further study. With contributions by notable forensic specialists, this volume shows the potential of this exciting new field and demonstrates how forensic nurses can make a difference in their communities and their profession.

More than 20 years ago it was recognized by Stoutenbeek and colleagues that patients in the intensive care unit suffered from infections developed whilst being treated. Moreover, the majority of these infections appeared to originate from bacteria that were acquired in the intensive care leading to pathologic colonisation and overgrowth in the gut, subsequently leading to organ site infections. Selective decontamination of the digestive tract (SDD) is an antibiotic strategy which aims to prevent secondary infections in critically ill patients. This book provides both the scientific rationale and the practical approach to nurses, physicians, pharmacists and microbiologists to design a SDD treatment strategy tailored to each individual patient and the local hospital situation.

New aspects of the place of cardiovascular drugs in anaesthesia addressed by Professor Pierre Coriat and a group of internationally respected authors in this important clinical Text.

The interactions of the current drugs used in major cardiovascular conditions are described, and therapeutic regimens recommended to counteract possible adverse effects during surgery or in the intensive care unit.

The first part of the book covers the pre- and perioperative management of surgical patients with disease of the cardiovascular system, with chapters on the current drugs in use:
β-adrenoreceptor antagonists
Calcium channel blockers
ACE inhibitors
Antiarrhythmic agents
α2-agonists

The second part discusses the maintenance of the acute cardiovascular patient on the intensive care unit, with chapters on:
Intraoperative hypertension
Postoperative hypertension
Prevention of myocardial ischaemia in cardiac surgery
Treatment of perioperative left ventricular dysfunction
Perioperartive arrhythmiasPulmonary hypertension
Pharmacological treatment of hyopoxaemia

Comprehensive coverage of clinical management is accompanied in a concise, well-referenced book that will become an essential reference work for all practising anaesthetists and intensivists.

Improving standards of care is a real challenge in Intensive Care Medicine. Bettering clinical performance, patient safety, risk management and audit represents the cornerstone for raising the quality of care in ICU patients. Communication is the platform from where to start to reach a consensus in an extremely crowded area, a unique multidisciplinary and multiprofessional environment in which quality of care and, ultimately, patient survival need to be ameliorated.

Verbrennungen kommen haufig vor, meist als Folge eines Unfalls. Manche Wunden heilen spontan, andere mussen in einem Brandverletzten-Zentrum versorgt werden. Dieses Kompendium bietet einen schnellen Uberblick uber den aktuellen Wissensstand zur Diagnose und Therapie von Verbrennungen. Erstversorgung, Flachen- und Tiefenbestimmung, chirurgische Versorgung, Haut und Hautersatz sind nur eine kleine Auswahl der behandelten Themen. Das Buch richtet sich an alle Berufsgruppen, die Verbrennungen behandeln, ob als Notarzt, Chirurg oder Pflegekraft.

When Trauma Survivors Return to Work: Understanding Emotional Recovery explains how managers and co-workers can learn to foster the process of emotional recovery for traumatized employees returning to the workplace. No other resource teaches managers and co-workers how to treat fellow co-workers returning to the workplace after experiencing a violent accident, rape, a burglary, or armed robbery. Or what to say to those who have just been told they have a terminal illness. Or how to treat an employee whose close family member has committed suicide. It is not helpful for co-workers to deny such traumatic events or remain silent, which is what happens. Or for managers to avoid directly communicating with traumatized employees. Is there a short and simple way to teach managers and co-workers how to be truly helpful to such wounded people? The answer is Dr. Barski-Carrow's illuminating, example-filled book, When Trauma Survivors Return to Work: Understanding Emotional Recovery.

International terrorism remains a significant threat to the peace of the world. Weapons using various materials and delivery systems have been directed against cities and infrastructure, and other materials are postulated to be usable within the near future. Some of these materials are unusual or exotic, while some are modifications of materials used daily for other purposes: biological, chemical, radiological, nuclear and explosive. These materials pose a safety challenge for first responders, slowing the response and potentially killing scarce trained personnel. This book provides information about how leading agencies across the NATO membership are preparing to confront and respond to terrorists deploying Weapons of Mass Destruction (WMD), Weapons of Mass Killing (WMK) and Weapons of Mass Disruption (WMDi). Based on contributions by experts from NATO member states, Israel and the Russian Federation, this book offers information on fourth generation warfare as a new challenge to first responders. It also provides a variety of insights into methods for preparing for and responding to WMD-, WMK-, and WMDi-events, using new technologies and strategies. Furthermore, the book offers solution for restoring the community to functioning after such a major terror attack. Topics include preparing, planning, operations, equipment, training and unique applications of existing technologies for countering terrorist attacks against cities and their infrastructure.

Advanced Medical Life Support, Second Edition is the leading course for prehospital practitioners in the advanced medical assessment and treatment of commonly encountered medical conditions. Taught throughout the world since 1999, Advanced Medical Life Support (AMLS) was the first emergency medical services education program that fully addressed how best to manage patients in medical crises. AMLS is the only textbook approved for use by NAEMT's Advanced Medical Life Support course, which emphasizes the AMLS Assessment Pathway, the most important guide for assessing patients with medical conditions. The United Kingdom edition of AMLS is enhanced by: Key Features Critical thinking scenarios give students a genuine context for the application of the knowledge presented in the chapter, including a scenario solution. Students are able to assess, review, and discern the possible diagnosis of the patient. Chapter review questions, chapter summaries, and Putting It All Together sections reinforce key concepts and tie information together, helping students retain what they have learned. Endorsed by the National Association of EMS Physicians and the United Kingdom College of Paramedics, the course emphasises the use of the AMLS Assessment Pathway, a systematic assessment tool that enables healthcare practitioners to diagnose medical patients with urgent accuracy. Current Medical Content Coverage of basic and advanced treatment modalities incorporate the latest research developments that are suitable for both beginning and experienced prehospital care providers, emergency and critical care nurses, and emergency doctors. An Updated AMLS Assessment Pathway The revised AMLS Assessment Pathway provides a systematic approach to the assessment of a medical patient and even more direction for students at all levels of practice.

PTSD is more usually considered as an adult disorder: this volume concentrates on children and adolescents. The introductory chapters are followed by a chapter on assessment and several chapters on treatment. The issues of clinical management in some of the important ecological contexts such as family and school, and aetiological contexts such as refugee status and child abuse, are discussed in further detail. Then a variety of treatment approaches are clearly described. The book is aimed at teachers, practitioners and researchers in child psychiatry, clinical child psychology, educational psychology, social work, paediatrics, and occupational therapy.